“Rosemarie Day, a healthcare consultant who worked to set up the nation’s first health insurance exchange in Massachusetts under then-Gov. Mitt Romney, wonders if Virginia could manage a single-payer system politically, if lawmakers haven’t even been able to agree on a ‘relatively safer step’ like Medicaid expansion. She thinks there is room for states to experiment with their own healthcare solutions, but she fears the process of moving to single-payer may prove too complex for Virginia to manage.
‘You’re going to take millions of dollars out of employer-sponsored insurance that they’re kicking in and replacing them with taxpayer dollars,’ Day said. ‘Maybe you contract with the feds to port over aspects of the Medicare program, but how do you suddenly disentangle all the contracts with providers and start new ones? There are so many things to unwind and replace with what a government entity would do. It would take years of work.’ ”
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